News Capsules

Published Online: Sunday, March 1, 2009

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Pharmacy Groups Address Medication Misuse

Pharmacy organizations recently unveiled
Pharmacy Principles for Health Care
Reform. The principles identify what is
necessary to fully use the medication
expertise to address the epidemic of
medication misuse. They demonstrate
how the nation's pharmacies and pharmacists
play a critical role in improving
accessible, affordable, and quality health
care for patients.

The 12 pharmacy organizations that
collaborated on its development outlined
3 goals related to medication access and
use that should be an integral part of any
healthy reform debate:

Proper use of prescription medications
help improve patient quality of life and
improve health outcomes. The health
care system, incurs >$177 billion annually
in mostly avoidable health care costs to
treat adverse events resulting from failure
to take medications as prescribed.

Pharmacists can help reduce those
costs through pharmacist-provided patient
care services, as well as administering
health screenings and immunizations.
With current costs to the health care
system to treat chronic diseases at $1.3
trillion annually, taking medications as
prescribed can help prevent the need for
catastrophic or emergency care.

Report Calls on Pharmacies to Reduce Diversion

A recent report by the Coalition Against
Insurance Fraud tasks pharmacies, pharmacy
regulators, and others in the field
to reduce the prevalence of prescription
drug diversion, particularly of controlled
analgesics.

The report, "Prescription for Peril:
How Insurance Fraud Finances Theft and
Abuse of Addictive Prescription Drugs,"
calls on the pharmacy profession to
provide additional training on prescription
drug abuse and diversion in pharmacy
education curricula and continuing
professional education. The report also
urges the industry to exert closer pointof-
sale scrutiny of certain prescriptions
and patients. Diversion, for example,
could be cut significantly if pharmacies
asked for photo identification in connection
with controlled substance prescriptions.

The report also recommends wider
adoption of prescription monitoring programs
to maintain statewide records
of narcotic prescriptions. Furthermore,
the coalition calls on lawmakers and
licensing boards to "swiftly and decisively
penalize the small fraction of prescribers
and dispensers who facilitate drug diversion
and abuse."

Ambulatory Care Pharmacy Practice Specialty Under
Consideration

The Board of Pharmaceutical Specialties (BPS) is holding open hearings next month
on the petition for the establishment of a new specialty in Ambulatory Care Pharmacy
Practice. The hearings are scheduled for April 5 and April 26.

Last November, BPS received a petition to consider this specialty, jointly submitted
by the American College of Clinical Pharmacy, the American Pharmacists Association,
and the American Society of Health-System Pharmacists. After its own review of the
petition and all comments received, the BPS will determine whether to recognize the
new specialty. A decision is expected later this year.

Indiana's Retail Health
Clinics May Face Tighter
Regulations

An Indiana Senate
bill would mandate
stricter requirements
for health
clinics located inside
retail businesses.
The new
protocols call for
greater involvement
of patients' primary
care providers (PCPs), as
well as higher levels of monitoring,
among other slated rules.

Under the law, retail clinics would be
required to submit reports to patients'
PCPs following each visit, as well as to
respond quickly to queries about patients
by their primary doctors. In addition,
clinic staff would be held to upholding
relationships with PCPs and other health
care professionals in the area who would
provide necessary referrals for follow-up
care, as part of oversight measures.

Monitoring also would take the form
of peer review, as well as review by
a collaborating physician, use of evidence-based guidelines, and collection
of data on outcomes and patient surveys.
Procedures for emergency response and
patient transfers to hospitals also would
have to be implemented.

Clinic staff would need certification
in cardiopulmonary resuscitation, and
equipment for both resuscitation and
defibrillation would be required on clinic
premises. The facilities would have to
demonstrate compliance with state and
federal laws and guidelines and undergo
inspections by the state to ensure conformity
to standardized medical protocols.

Electronic health records would be
mandated for the clinics, and staff there
would have to provide patients with
written information on their conditions.
Other requirements would include the
visible posting of a price list for services
and the separation of the clinic from the
retail portion of a business, which would
include separate entrances.

Mediterranean Diet May
Ward Off Dementia

The Mediterranean
diet may help prevent
mild cognitive
impairment
and also
reduce the
odds of transitioning
from
mild cognitive
decline to
Alzheimer's disease
(AD), according
to the study reported
in the February 2009 issue of the Archives
of Neurology.

The study, based on 4? years of
follow-up, found that 275 of the 1393
patients who did not have mild cognitive
impairment developed the condition. The
patients who followed a Mediterranean
diet had a 28% lower risk of developing
mild cognitive impairment, compared
with one third of participants who had
the lowest scores for diet adherence. The
middle one third group had a 17% lower
risk of developing mild cognitive impairment,
compared with those who ate the
fewest Mediterranean foods.

Of the 482 patients who had mild
cognitive impairment at study onset, 106
were diagnosed with AD nearly 4 years
later. The one-third of patients with the
highest scores for Mediterranean diet
adherence had 48% less odds of developing
the disease, compared with the lowest
diet scores.

Mediterranean cuisine consists of a
menu plentiful in vegetables, legumes,
and fish, low in fat, meat, and dairy, and
high in monounsaturated fats.

Cancer Will Beat Heart Disease as Global Top Killer

International health experts predict that cancer will surpass heart disease as the
world's top killer by 2010, part of a trend that should more than double global cancer
deaths by 2030.

The World Health Organization (WHO), which released the report, attributed rising
tobacco use in developing countries as a major reason for the shift, especially in China
and India, where 40% of the world's smokers now live. WHO says that an annual rise of
1% in cases and death is expected—with larger increases in China, Russia, and India.
This means cancer cases will likely balloon to 27 million
annually by 2030, with deaths reaching 17 million.

By 2030, WHO reports there could be 75 million
people living with cancer around the world, a figure
that many health care systems are not equipped to
handle. "This is going to present an amazing problem
at every level in every society worldwide," said Peter
Boyle, director of WHO's International Agency for
Research on Cancer.

The organizations are requesting governments to
act, asking the United States to provide funding for
cervical cancer vaccinations and to ratify an international
tobacco control treaty.

Lawmakers Reject Pharmacy Cuts in Two States

Despite budgetary woes, legislators in New York and Vermont voted against funding
cuts for pharmacy services. In New York, a proposal to reduce pharmacy reimbursement
for brand name drugs was rejected, and Vermont lawmakers voted down a
measure that would have done away with a prescription program for seniors and
disabled individuals with low income.

The proposed New York cuts would have chopped pharmacy reimbursement for
brand name medications received through Medicaid and the Elderly Pharmaceutical
Insurance Coverage Program to average wholesale price minus 17.25%.

Although the industry has averted the cuts, pharmacies in New York took a massive
hit last year, with 152 drugstores closing doors due to $100 million in stateimposed
reductions over the past 6 months alone. In Vermont, the House Human
Services Committee voted down Republican Gov James Douglas' proposal to eliminate
VPharm, a program for low-income seniors and people with disabilities. Because the
program, established in 2006, is part of state statute, it cannot be dissolved in order
to reduce the state tab. Instead, the committee is looking at ways to reduce costs for
the program.

Douglas is seeking to achieve other savings from the pharmacy arena. A 4% cut to
dispensation fees paid to pharmacies for each Medicaid prescription filled is slated to
save about $5 million, among other Medicaid reductions that are part of the governor's
fiscal year 2010 budget.

Wyoming Law Would Make Prescription Fraud a Felony

A bill currently before the Wyoming Senate would attach a felony charge to drug
prescription forgery. The proposed legislation seeks to assign a penalty of up to 10
years in prison with possible fines of up to $10,000 for those found guilty of forging or
altering prescriptions to acquire controlled substances.

Not limited to physically altering or forging a prescription, the bill includes past
provisions regarding the use of any type of misrepresentation or deception to obtain
prescription drugs unlawfully. Set to go into effect July 1, 2009, if passed, the bill is an
amendment to the Wyoming Controlled Substance Act of 1971.